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Critical Care

Featured Researcher — Katherine Bline, MD
 Featured Researcher — Katherine Bline, MD 150 150 Katie Brind'Amour, PhD, MS, CHES
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Katherine Bline, MD, is a critical care medicine physician and principal investigator in the Center for Vaccines and Immunity at Nationwide Children’s Hospital. Experience caring for some of the hospital’s sickest children in the pediatric intensive care unit (PICU) and mentors who pushed her to understand phenomena she observed clinically have helped Dr. Bline find…

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Role of Myeoloid-Derived Suppressor Cells in Septic Shock Immunoparalysis
 Role of Myeoloid-Derived Suppressor Cells in Septic Shock Immunoparalysis 1024 683 Mary Bates, PhD
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New study is the first to describe increased myeloid-derived suppressors cells in children with septic shock. In children with septic shock, the immune system initiates a systemic inflammatory response and a nearly concurrent compensatory anti-inflammatory response. When severe, this anti-inflammatory response is termed “immunoparalysis” and is associated with increased risk of infections and death. Researchers…

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Using Machine Learning in the Electronic Medical Record to Save Lives
 Using Machine Learning in the Electronic Medical Record to Save Lives 1024 683 Abbie Miller
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physicians in white coats looking at a tablet

The deterioration risk index identifies patients at risk for deterioration and poor outcomes, triggering the care team to act before a crisis happens. In a report published in Pediatric Critical Care Medicine, a team from Nationwide Children’s Hospital describes a machine learning tool for timely identification of hospitalized children at risk for deterioration – a…

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COVID-19 and Neurologic Manifestations in Children
 COVID-19 and Neurologic Manifestations in Children 1024 512 Marlina Lovett, MD
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coronavirus

Just weeks after SARS-CoV-2 was identified, global consortiums were formed to combat the pandemic. Health care providers and scientists worked together to learn how SARS-CoV-2 impacted the body, to share information, to generate hypotheses and to develop treatment approaches. The Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) was designed to provide insight into…

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Learning in Real Time to Overcome COVID-19 and MIS-C
 Learning in Real Time to Overcome COVID-19 and MIS-C 1024 491 Natalie Wilson
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Illustrations of clock faces at different times and angles

When multisystem inflammatory syndrome in children (MIS-C) emerged in May 2020, the new condition made headlines. Although rare, MIS-C can appear in kids about a month after they’ve recovered from infections with SARS-CoV-2, the virus that causes COVID-19 — even if they haven’t felt sick at all. “We don’t know why some children develop MIS-C,”…

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EVALI and MIS-C: Overlapping Diagnoses
 EVALI and MIS-C: Overlapping Diagnoses 1024 575 Mary Bates, PhD
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Taking a thorough history can differentiate these similarly presenting conditions. In a new report, researchers from Nationwide Children’s Hospital describe six patients admitted to the hospital with concerns for MIS-C who were later diagnosed with EVALI. The researchers discuss the factors that led them to differentiate between the two disorders and arrive at the correct…

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Taking on Bronchiolitis in the Age of COVID-19
 Taking on Bronchiolitis in the Age of COVID-19 1024 575 Eric Butterman
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small baby with nose canula

In a recent episode of PediaCast CME, Drs. Asuncion Mejias and Gerd McGwire address the diagnosis and management of bronchiolitis – and special considerations during the COVID-19 pandemic. Bronchiolitis is the leading cause of hospitalizations for young infants around the world, and in a year with a respiratory pandemic, everyone is a little uneasy about…

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Study of Children With COVID-19 Admitted to US and Canadian Pediatric Intensive Care Units
 Study of Children With COVID-19 Admitted to US and Canadian Pediatric Intensive Care Units 1024 683 Abbie Miller
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Publication examines the characteristics and outcomes of children with COVID-19 who were admitted to North American PICUs. While two studies from Wuhan, China, have indicated that COVID-19 disease burden and severity seems to be lower in children, it remains to be seen how children around the world will fare as the pandemic progresses. In March…

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Skin-to-Skin Care Safe for Infants After Surgery
 Skin-to-Skin Care Safe for Infants After Surgery 150 150 Mary Bates, PhD
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A quality improvement project shows that skin-to-skin care can be safely integrated into the treatment of infants who require surgery. Multiple barriers prevent routine skin-to-skin care for infants in the neonatal intensive care unit (NICU), particularly for infants requiring surgical consultation. A recent quality improvement project, published in the Journal of Pediatric Surgery, shows that routine…

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Targeting Therapies for Children With Multiple Organ Dysfunction
 Targeting Therapies for Children With Multiple Organ Dysfunction 1024 575 Kevin Mayhood
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Anakinra, an interleukin-1 receptor antagonist, may be effective for selective children with MODS who meet diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Multiple organ dysfunction syndrome (MODS) involves altered function of two or more organ systems and is among the most severe forms of critical illness, with mortality rates up to 50 percent in children. MODS…

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Concussion is Associated With a 2x Higher Risk of Suicide
 Concussion is Associated With a 2x Higher Risk of Suicide 150 150 Jeb Phillips
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Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis
 Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis 1024 575 Rachael Hardison
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Black and white photo of boy sitting up on hospital bed

Appendicitis is one of the most common indications for abdominal surgery in children. Accurate, efficient diagnosis is critical for initiating timely treatment. Current imaging options for diagnosing appendicitis include ultrasound and computed tomography (CT). CT scans, while readily available and highly sensitive, require radiation exposure that can increase the risk of malignancy over the child’s…

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Mapping the World of Pediatric Severe Sepsis
 Mapping the World of Pediatric Severe Sepsis 1024 576 Katie Brind'Amour, PhD, MS, CHES
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Blood cells

Researchers work to reveal the many subtypes of pediatric sepsis — and what to do about them. Once upon a time, sepsis was just sepsis. Children experiencing septic shock and its aftermath — any resulting organ failure — were viewed as a fairly homogenous group of patients. But now, thanks in a large part to…

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Solving the Puzzle of Transfusion-Related Immune Reactions
 Solving the Puzzle of Transfusion-Related Immune Reactions 576 367 Katie Brind'Amour, PhD, MS, CHES
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Now that physicians have the “how” of blood transfusions mastered, they are starting to explore the “what” — and they’re learning that the effects of sharing human blood may be even more far-reaching and complex than previously imagined. With the initial safety challenges addressed and the technical barriers of donor blood storage and cleaning improved,…

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Care Bundles Can Reduce Hospital-Acquired Pressure Injuries
 Care Bundles Can Reduce Hospital-Acquired Pressure Injuries 150 150 Brianne Moore
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Reliable implementation of care bundles reduces the number of serious hospital-acquired pressure injuries Hospital-acquired pressure injuries (PI) are a significant cause of preventable harm that can increase hospitalization costs and length of stay. Up to 27 percent of pediatric intensive care unit (PICU) patients and up to 23 percent of neonatal intensive care unit (NICU)…

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Balancing Immune Activation and Suppression After Cardiopulmonary Bypass
 Balancing Immune Activation and Suppression After Cardiopulmonary Bypass 150 150 Mary Bates, PhD
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Understanding how the immune system responds to CPB could dramatically impact postsurgical outcomes. Cardiopulmonary bypass (CPB) is a relatively routine procedure, generally with favorable outcomes. However, among the risks posed to patients is the over- or under-activation of the immune system following the surgery. Mark Hall, MD, FCCM, division chief of Critical Care at Nationwide Children’s Hospital,…

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From Military Zones to Pediatric Trauma Centers, Implementing Massive Transfusion Protocols
 From Military Zones to Pediatric Trauma Centers, Implementing Massive Transfusion Protocols 150 150 Abbie Miller
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While military and adult research has shown massive transfusion protocols to be lifesaving, implementation and validation in pediatrics lags. When someone is critically injured with life-threatening bleeding, the primary objective of the care team is to stop the bleeding and replace the lost blood. Historically, children in this situation were administered red blood cells (RBCs)…

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Revealing the Secrets of Sepsis
 Revealing the Secrets of Sepsis 969 533 Abbie Miller
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Illustration of NK Cells, T Cells, other immune cells floating across white background

Charting new territory in the understanding of how the immune system responds to sepsis. Two children are admitted to the hospital with sepsis. Both receive antibiotics and fluid resuscitation within the critical first hour. Why does one get better after the initial crisis while the other goes on to develop additional infections and multiple organ…

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Illuminating Vasospasm in Children with Traumatic Brain Injury
 Illuminating Vasospasm in Children with Traumatic Brain Injury 150 150 Jan Arthur
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Understanding reasons for dangerous vessel constriction following brain injury may help define treatment or prevention options. Vasospasm, or severe narrowing of blood vessels, is a dangerous complication observed in children with moderate to severe traumatic brain injury. In a paper recently published in Critical Care Medicine, investigators at Nationwide Children’s Hospital have further defined the prevalence,…

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